THE .

GENIUS OF MEDICINE.

BY

ROBERT B. S. HARGIS, M. D.,

PENSACOLA, FLA.

Action and reaction are fundamental phenomena of the intellect¬

ual as of the physical world. The “method of nature,” in all its
phases strikes us the more we learn, by its exquisite simplicity and
stupendous grandeur. To none other, need the profession of med¬
icine yield the palm, in asserting its claims on humanity, for the light
it has shed on that method. It is well for us occassionally to ponder
over the influence of our colleagues, in the past and present. We
lack historians. No busy practitioner, isolated from the learned in
large cities, and deprived of the essential advantages of consulting
libraries, can presume to unfold with precision the influence of med¬
ical thought on the human understanding. The theme is captivating.
How does the history of man indicate the status of Medicine at
different epochs ; and on the other hand, what has medicine radiated,
from within its special limits of searching experiences and glowing
energy, to comfort and advance mankind ? I am proud to say that
from the days of a pure empiricism, through an era of gloomy
superstition, to the final adoption of the scientific method, physicians
have ever been in the van amongst men of action. It is proverbial that
throughout the world, medical students have ever been the prompt¬
est defenders of human liberties, the most valiant knights in assault¬
ing with positive recklessness, the entrenched fastnesses of authority
and dogmatism. The science of medicine is nothing unless pro-
2 THE GENIUS OF MEDICINE.
i - - ■ .. — --

gressive. Intellectual life amongst us lias long since compelled the

decent burial of many doctrines imposed on the world by an Aris
totle or a Galen, a Boerhaave, or a Hahnemann. Dead and buried are
all human fictions in medicirfe, and nothing stands but the solid and
growing edifice of a truly inductive science. We have wearied with
the rest of mankind of teleological research. Our pre-occupied
hours are too short for vague imaginings in relation to the doctrine
of final causes, but we have raised a structure on rocks, moulded by

astute experimenters, and whose substrata are as bi’oad as nature’s

entire domain, the universe. Ancient history reveals how much man
suffered by confounding temporal with spiritual duties. Appeals to gods
who ruled over the destinies of each particular organ resulted in
never-ending disappointment. It is true that we are lost in aston¬
ishment at the vast knowledge indicated by the hygienic precepts of
Moses. The social institutions of Egypt, the astute control of a rev¬
erent people, the rude awakenings due to plague out-breaks and
famines, established rules of conduct and sanitary precepts over
which we marvel and which we may well strive to enforce, in many
respects, to-day. The Levites constituted an hereditary nobility,
and were both the judges and the doctors of the people. Solomon,
the most learned of men, wrote on the cure of diseases by natural
means, and Ezekiah is charged with destroying this work, which in¬
terfered with the interests of the Levites. What a contrast if we

pass from this to the contemplation of a pure idealism and its in¬
fluence on medicine Maladies were ascribed to the fury of gods
and godesses, Isis, symbolizing the Moon, was regarded as induc¬
ing diseases which recurred periodically. She restored her son Orus
to life. Since it was her anger that afflicted men with disease,
the Greeks compared her to Proserpine, Queen of Hell, or to the re¬
doubtable Hecate.

Whenever freed from state succor and control, medicine raised its
head, as in Palestine. In India, 1400 years before Christ, skilled
writers compiled a summary of all medical works then in existence —
the “ Ayur Veda,” the most ancient of the sacerdotal medical writ¬
ings, and from this came Vaidya, a medical caste among the Hindoos.
To iEsculapius, son of Apollo and Coronis, does Greek mythology
ascribe the origin of medicine, Melampus was the first medical
practitioner in Greece. The priests in charge of the iEsculapian
temples were supposed to have powers imparted to them, such as. the
American Indians ascribe to their medicine men. Human curiosity
 THE GENIUS OF MEDICINE. 3

and ingenuity, amongst a people capable of vigorous mental growth,

led to the priests recording the cases and cures coming under their
daily observation. The most celebrated of the temples reared to the
worship of iEsculapius were those of Rhodes, Epidaurus, Cnidos
and Cos. In the latter place the immortal Hippocrates was born,
B. C., 450 years. He was the son of Heraclides, a professed physi¬
cian. Hippocrates is the true ancestor of experimental medicine.
He. examined the recorded cases, as set forth on the votive tables of
the temples0 His acute perception rendered him a shrewd statisti¬
cian and bold generalize!-. He perceived the periodicity of disease,
and may be said to have formulated the law of “ Crises.” A retro¬
spective glance of the school of Cos, reminding us that Pericles and
Socrates, then lived, and that Praxagoras and Herophilus led on to
the great Alexandrian school of medicine, almost causes us to imag¬
ine that the great Grecians were as highly endowed mentally as the
greatest medical philosophers of the 19th century. The unrivalled
eminence of Greek art likewise would induce us to believe that man
since then may actually have lost much of his cunning. But a
broad survey of conflicts and conquests, since the days of Hippo¬
crates, force on our acceptance the juster view that, notwithstanding
periodical retrograde movements, human intellect and resources to¬
day enable the industrious amongst us far to out-strip the ancient
Grecians. Isolation, accounts for the immortality of the great
Grecians. No such fame can be the reward of greater achievements
by the greatest of the host devoted now to our noble calling ; we
may well contrast the physicians of to-day with those of the Hippo¬
cratic period, as we compare the naturalists of the 19th century w.th
those of the early dawn of the Christian era. There is nothing more
startling than the atomic theory of Democritus. He visited Athens
where Socrates and Plato lived, traveled far and wide to acquire
knowledge, embodied in his Diakosmos, and started the germinal
thought that nothing out of nothing came, and that matter was in¬
destructible. For him atoms and empty space were alone existent.
It is not my purpose to speak of Epicurian and Lucretian philos¬
ophy, but it is important that we should fix our attention to the fact,
that at this period of intellectual activity and bold speculation, the
first beginnings of the scientific method in medicine, advanced with
the labors of mathematicians, like Pythagoras, and culminated in
the Alexandrian School, Then “Euclid ” wrote his “Elements ” and
made some advance in optics. Archimedes had propounded the
4 THE GENIUS OF MEDICINE.

theory of the lever and the principles of hydrostatics. Astronomy

was immensely enriched by the discoveries of Hipparchus, who was
followed by the historically more celebrated Ptolemy. Anatomy
had been made the basis of scientific medicine, and it is said by

Draper that vivisection had begun. In fact, says “Tyndall,” from

whom I am quoting, “the science of Ancient Greece, had already
cleared the world of the fantastic images of divinities, operating
capriciously through natural phenomena. It had shaken itself free
from that fruitless scrutiny by the internal light of the mind alone,
which had vainly sought to transcend inference and reach knowl¬
edge of ultimate causes, instead of accidental observations with a
purpose ; instruments were employed to aid the senses, and scien¬
tific method was rendered in a great measure complete by the union

of Induction and Experiment.” Our forefathers, in their thirst

for knowledge, were not particular as to how they acquired it, and it
is said that during the reign of the first Ptolemy, criminals were
sometimes dissected alive by physicians. In the days of Ptolemy
the 2d, Philimus of Cos, a Greek physician of eminence, founded
one of the earliest medical sects, the Empirici.

No figure in ancient history stands out so prominently as Aristotle’s.

He was son of an eminent physician, Nicomachus, and was born at
Stagira, in Thrace, 384 years before Christ. His love for natural history

was hereditary. In philosophy, he was Plato’s pupil, Plato said,

“Aristotle is the mind of my school.” Plato and Aristotle contain all
the speculative philosophy of Greece, but the influence of the last
completely overshadowed that of his teacher, and for twenty centuries
continued to exercise a tyrannic and pernicious sway over the minds
of men. He taught that reason alone can form science. Experience
being the basis of all science, reason was the architect. He opened the
world again to speculation, which Socrates had suppressed. With¬
out taking into consideration Aristotle’s teaching and, in many senses,
enervating example, it is impossible to comprehend the drift of the
arts and sciences, including medicine, during the long period inter¬
vening between the Alexandrian school and the days of Bacon. The
most striking instance of Aristotelian control over the minds of men,
is afforded by Galen, born at Perganrus, A. D., 130. He compiled a
cyclopaedia of medical literature, the text book for upward of thirteen
centuries.
During the so-called dark ages we can only glean data for a gloomy
picture of medical progress. Prior to the Christian era, astrologers
 THE GENIUS OF MEDICINE. 5

and incantations were resorted to. Certain stars were supposed to

rule over distinct parts of the human frame. Saints took the place
of the stars with the Christian priesthood, and both stars and saints
were alike prejudicial to the advance of medicine. In due time the
priests, becoming wealthy, neglected the church, and the Council of
Laodicea, A. D., 306, forbade their studying or practising astrology ;
but they continued to be the most popular doctors until the Lateran
Council, held A. D., 1123, ordained that priests and monks should
not attend the bedside of the sick in any other capacity than as
ministers of religion. At another council, held in Iiheims, A. D.,
1131, monks were prohibited from frequenting schools of medicine.
Successive injunctions and prohibitions tended to divorce the sur¬
geon or physician from the priest, but the separation did not occur
fully till a Bull was issued by Pope Innocent the Third, permitting
those priests who practised medicine to marry. Ever since that time
the professed physician has been a layman.
The dawn of modern medicine came with Mondini, the Anatomist
of Bologna, early in the fourteenth century, and his pupil, Guy de
Chauliac, in France, gave an immense impetus to surgery. Aris¬
totelian methods were successfully counteracted by Ambroise
Pare, who defied the schoolmen successfully, confronting their

fallacies and false teachings by appeals to nature 'and the dissecting

table.

In the fifteenth century, Leonardo da Yinci, the great Italian nat¬

uralist and artist, proclaimed that air was essential to combustion,
and that no animal can exist in an atmosphere which is incapable of
supporting combustion. Here was the earliest known theory estab¬
lished in ways not known to us, leading up to a rational understand¬
ing of the function of respiration. To Francis Bacon, born on the
22d of January, 1561, we owe the Novum Organum. He was the
first to proclaim a philosophy of science, based on accurate verifica¬
tions which Aristotle had ignored. His mind was antipathetic to all
metaphysics, and he is justly entitled the Father of Positive Scieuce.
Now we can fully appreciate the wisdom of his declaration that

Physics was “ The Mother of all the Sciences.” What physiologist

can gainsay that? In his classical treatise on the subject of Heat,
as well as in his Novum Organum, Lord Bacon maintained that the
very essence of heat is motion and nothing else. He was the embod¬
iment of the anti-Aristotelian school, He attacked Aristotle’s philoso¬
phy as “ only strong for disputations and contentions, but barren of
6 THE GENIUS OF MEDICINE.

the production of works for the benefit of the life of man.’' He

scorned the traditions of the past, but unfortunately for his reputa¬
tion, he likewise held in contempt the researches of Copernicus and
Gilbert, that brilliant physician, Dr. Gilbert, of Colchester, whose
Physiologia Nova was published in 1(500. Gilbert was appointed
physician in ordinary to Queen Elizabeth, but a brighter diadem
shone on his forehead as the discoverer of terrestrial magnetism. He
introduced the name of pole to the extremity of the needle, as
pointing towards each pole of the earth, and first spoke of electric
force and electric attraction. He experimented on heat in relation
to magnetism, and by his writings enlightened the curious in his field
of research for two centuries after his death. He is not yet quite
hidden from view, and let us not forget he was a practising physi¬
cian. The Italians were in astronomy, physiology and the practice
of medicine the most active followers of Bacon’s method.
One of the least known to English readers, but most remarkable
and illustrious of all the physiological investigators of the seventeenth
century, was Francis Redi, born at Arezzo, on the 18th of February,
1626, a student of the University of Pisa, where he became doctor of
philosophy as well as of medicine, and a physician of the court of
Tuscany, acquiring not only local but European fame, beyond any of
his contemporaries. He was a man of the highest culture, a writer
of the purest Italian, a poet and philosopher, but devoted chiefly to
experimental science and natural history. His treatise on vipers, his
experiments on the reproduction of insects, his observations on living
animals, all attest to the breadth and depth of his knowledge, as well
as to his strict adherence to Bacon’s method of verification. He
belonged to the school of Galileo, and wras inspired by the progres¬
sive spirit of his times as an academician of the illustrious Academy
del Cimento. He overthrew the universal belief in insects being
developed spontaneously as a result of putrefaction. In relation to
snake poison, he described the glands secreting it, the tooth which
introduces it into a wound and the harmlessness of the poison if
passed into the stomach, without coming in contact with a sore.
Redi may be fairly styled the Jonn Hunter of the Italian school in
the seventeenth century. He animated and developed the true ex¬
perimental method, which was so soon to prevail over Western
Europe ; and take deep root in the British Isles. Historians tell us
that with the entry of Charles the Second into Whitehall, modern

England began. We find ourselves, says Green, “all at once among

 THE GENIUS OF MEDICINE. • 7

the great currents of thought and activity, which have gone on

widening and deepening from that time to this.” The revolution led
to all the infamy, intrigue and disorder which comes from a revulsion
from strict discipline such as the Puritans established. But the Court
and town were more deeply fouled than the people, whose increase
and sound sense favored the growth of purer thought and solid

science, as the basis of England’s unrivalled greatness, and I may

add of America’s present and most glorious prospects. Kepler and
Galileo were at this epoch creating modern astronomy, and Descartes
revealed the laws of motion. The continent of Europe numbers many
illustrious in physical, physiological and medical researches, whereas
England counted, with Bacon and Gilbert, the illustrious Harvey.
He was the pupil of Frabricius ab Aquapendente, at Padua, and with
a profound knowledge of acquired truth, capped the pyramid of
science with his great induction, the discovery of the blood’s circu¬
lation. Redi’s influence is perceived in the aphorism, “ omne vivum
ex ovo. The doctrine of spontaneous generation was forever laid
low. It has been repeatedly revived, but always to be refuted by
experimental proof of the imperfect observations of its advocates.
Aristotelian disciples werenot fully extinguished. Science to this
day is hindered by them; Stahl, likewise a physician, who flourished
from 1660 to 1734, imposed on the world his doctrine of phlogiston.
He declared this to be the only principle of combustibility. He
descanted likewise on an immaterial essence- — an organizing prin¬
ciple which he termed the ‘Amima ” endowed with intelligence and
pervading man. This anticipated Boerhaave, who maintained that the

living body was governed by “ an universal catholic fluid,” the most

elastic principle in nature, termed by the Greeks “Animus Mundi/
With the establishment of the Royal Society in 1662, we have the
era of Lower, Boyle, Hooke and Mayow, who laid the foundation
for British preeminence in physiological science, by their researches
on respiration. Ihey demonstrated the absolute dependence of
animals on the atmosphere they breathed. By sustaining artificial
respiration, Hooke proved in 1664, that the essential phenomenon of
respiration is the admission of air to the lungs, and Dr. Richard
Lower, of Oxford, who had practiced transfusion, proved by opening
the chest of living animals, the change occurring in the blood on the
passage through the lungs from dark venous to bright arterial red.
Hooke was the pioneer in the true theory of combustion which ten
years later Mayow was to advocate. Dr. John Mayow, born in 1645,
 8 THE GENIUS OF MEDICINE.

in Cornwall, described, in 1694, the experiments which led him to

conclude that atmospheric air contains a substance that he denom¬
inated Nitro-serial spirit, which is consumed when bodies burn as
well as when animals breathe. He placed animals under bell jars
containing air and dipping them in water, he found that the volume
of air gradually diminished. He believes that, in the process of
respiration, the venous blood circulating in the lungs combined with
' the mtro-aerial spirit of the respired air, and that combination was
attended with the evolution of heat, which served in part to maintain
the animal temperature. He believes that in the process of respira¬
tion, gaseous impurities are removed from the blood.
Mayow supposed that the rusting of iron in air was due to its
combination with nitro-serial spirit, and he determined that when
antimony is burned in it, it increases in weight in consequence of its
having combined with the substance, whose existence he had sur¬
mised, and which was discovered, a century later, by Priestley and
Scheele, namely oxygen.
Mayow died at 34 years of age, but his prolific brain and industry
won for him the great distinction of being one of the earliest pioneers
of Modern Chemistry. Much as medicine is reaping from the Chem¬
ical Laboratory to-day, she may claim a large share in initiating a
sound chemical philosophy. In an essay on science and medicine,
published in 1874, Dr. Arthur Gamgee says : “Aristotle had declared
large animals respire, but that small ones do not, basing the latter

statement on the supposed fact that insects do not breathe.”

Boyle’s experiments with the air pump (facilitated by Dr. Hooke’s
apparatus, which was a great improvement on Otto de Guerricke’s
of Magdeburg), proved however, the fallacy of the assertion and his
physiological discovery was confirmed by the researches of the dis¬
tinguished Italian anatomist, Malpighi, who describes the respiration
of insects in a remarkable work on the silkworm, which he dedicated
to the Royal Society in 1669, having been elected a Fellow but one

year previously, and further, “whilst these researches were being

carried out, Dr. Thomas Willis was adding to our knowledge of the
Anatomy of the brain, being aided in his researches by Lower, and
availing himself of the pencil of Sir Christopher Wren, and about
the same time, another Fellow of the Royal Society, Clopton Havers,

was contributing to our knowledge of the structure of bone.” With

the opening of the 18th century we have an edifying view of the
 THE GENIUS OF MEDICINE. 9

progress of medicine as studied in the Universities of Leyden and

Edinburgh.
Hermann Boerhaave, appointed to the chair of medicine in the first,
in 1709, proved a good teacher but loved hypothesis. Yan Swieten and
Haller rescued his school from any charge of barrenness, much as we
know that his direct influence was not that of a Redi or Harvey. A far
greater man, an equally potent teacher in the class-room, but a more
solid guide in science established the reputation of the University of
Edinburgh as a school of physic. William Cullen, who lived from 1710
to 1790, was first apprenticed to a physician, took his M. D. in Glasgow
in 1710, practiced at Hamilton and was afterwards professor of Chem¬
istry kin the University of Glasgow. He was conspicuous for his attacks

on what he called “false Jacts.” He • was the most uncompromising

searcher of fallacies in the laboratory. He had but one course to pur¬
sue when a statement or a novel observation struck him. He resorted

to every expedient whereby he might determine its truth. Like Boer¬

haave, he was essentially devoted to the actual teaching of youth, and
the lore buried with him was, in all probability, but imperfectly indi¬
cated by his writings. Essentially a physician, he was, to a far greater

extent than is generally appreciated, Dr. Joseph Black’s master and

predecessor. Physicists were discussing the singular phenomenon
attending the evaporation of liquids. Richmann and others had
confused ideas of chemical combination with the air, inducing the
cold attendant on the dispersion of volatile agents. Cullen experi¬
mented and proved that heat, and heat alone, sufficed for this change
of state in matter. He likewise pointed out a direct relation between
the cold produced and the volatility of the fluid used. He moreover
said — “ the cold is made greater by whatever hastens the evaporation
and the sinking of the thermometer is greater as the air in which

the experiment is made warmer, if dry at the same time.” “Cold,” he

said, “ is the effect of evaporation.” The experimental inquiry is at
the foundation of Black’s and Watt’s researches on latent heat. A
great Russian, to whom Mr. John Gamgee has of late directed atten¬
tion, Michael Lomonosow, at the period recognized “ the sufficient
cause of heal as consisting in the motion of matter .” Undoubted famil¬
iarity on the part of Cullen with contemporary research and with
Richmann’s labors, published in the same volume, of the Transactions
of the Academy of Science of St. Petersburg, as Lomonosow’s essays,
would indicate that the greatest invention of modern times, the steam
engine, was not born in the workshop, as practical mechanics insist,
10 THE GENIUS OF MEDICINE.

bat sprang from halls of science where James Watt met with his
most congenial associates. A true theory of combustion was un¬
doubtedly formulated by a physician and the greatest medical teacher
of the Scotch school, whose influence in this respect has to this day
been felt, was the active pioneer in researches without which the
steam engine had remained inchoate for a long and indefinite

period.
Dr. Hooke had been Newcomen’s wisest counsellor and brought
the data of Galileo and Torricelli to bear on the practical work of
the millwright, but reliance on atmospheric pressure and wasteful
processes, could alone be set aside by a better understanding of the
laws of vaporization. In 1728, there was born in Bordeaux, France,
of Scotch parents, Joseph Black, who pursued his studies in Glas¬
gow, and in 1754 took his degree as Doctor of Medicine in the

University of Edinburgh. At that time, according to Stahl’s doc¬

trine, plogiston, or a fire essence, was supposed to be the cause of
the causticity of alkalies. Black proved that it depended on their
combination with fixed air ; or what is now known as carbonic acid,
a discovery which Lord Brougham declared was the result of
“Incontestably, the most beautiful example of strict inductive in¬
vestigation since the optics of Sir Isaac Newton.”, In 1756 he suc¬
ceeded his own master, with whom he had pursued his laboratory
researches, as chemical professor in Glasgow. In 1756, he attracted

the world’s attention by his splendid work on latent heat. It was

also in 1756 that James Watt, after a year’s residence in London, re¬
turned to Glasgow, still a youth in his 20th year. He was sheltered
from the tyranny of Guilds, by Dr. Dick, who employed him to
repair some apparatus belonging to the University. He was per¬
mitted to occupy three rooms and remain there in intellectual society

till 1760. Black’s favorite pupil, John Robinson, who was Watt’s
junior by three years, became his intimate friend and adviser, and in
1759 suggested the propulsion of carriages by steam and forcibly
pointed out to Watt the importance of the steam engine. Chem¬
istry was studied by Watt under Dr. Black, and for years the latter
expounded to his class the phenomena of heat disappearance, during
the conversion of water into steam, so that he was enabled to afford
Watt a rational explanation, when the latter directed his attention to
the fact, that it took a small quantity of steam to heat a very large

volume of water. I shall not attempt to follow the detail of Watt’s

work. Suffice it to say that perceiving the greater amount of heat
 THE GENIUS OF MEDICINE. n

held, weight for weight, by steam as compared with water, he

devoted years of thought and successful practice, to avoiding every
possible useless waste of that heat in developing power. Dr. Black,

starting from Cullen’s experiments, was not only the first discoverer
of the doctrine of latent heat, but he likewise demonstrated that it
requires a very different amount of heat to raise the temperature of
different bodies one degree.
The French Academy of Surgery had, since 1731, encouraged and
fostered the experimental method in medicine. It was raised “ on the
basis of chemical observation, physical researches and experiments1”
Thus the distinctly positive course of advancement, springing from
Italy, invaded England, flourished with brilliant effect in France, and
in William and John Hunter’s hands again became consolidated in
Great Britain. William Hunter was a pupil of Cullen. He essentially
belonged to the experimental school. It were needless to encumber
this sketch with special reference to John Hunter’s labors. He was the
master hand of his epoch. Names begin to thicken, and everywhere
the medical mind is found exerting an immense influence on human
progress. Scarpa, Porta, Amussat, Hewson, Astley Cooper, Travers,
Arnott, and a host receding daily from view, owing to crowded genera¬
tions of distinguished men, succeeding them in the medical world, suf¬

ficiently attest to the vast influence exercised by 'our profession on

the develhpment of man. The fact that Watt progressed so far and
no further than a knowledge of laws relating to the production and
condensation of steam then established by the Glasgow School of
Physics and himself, has been forcibly put by Professor Osborne
Reynolds. Watt dealt with steam at the pressure of the atmos¬
phere. He was aware that high pressure steam could be expanded
to advantage, but although he had some of the facts before him the
advantage only became apparent on the discovery of further laws
relating to steam, and these laws were not discovered until our own

time.” “For fifty years there was no advance, just as there had pre¬
viously been none with the fire engine, and it was not until the further
discoveries in the action of steam and heat” that there was a decided
step towards increasing the pressures at which engines work. As
far back as 1824 Sadi Carnot stated the law which controls present
practice, but it lay barren until the science of Thermodynamics was
born. And who assisted at that birth ? I have not time to relate
how Rumford, Davy and many more paved the way for the brightest
epoch in the history of positive science, when the do', trine of energy’
12 THE GENIUS OF MEDICINE.

foreshadowed by Dr. Young, led to the definite foundation and

recognition of the true laws of heat, and the great theory of the con¬
servation of force. And to whom does the world preeminently owe
this? To a practising physician, Di\ Julius llobert Mayer, born at
Heilbronn, November 25th, 1814. In 1840 he made a voyage on a
Dutch freighter to Java, and it was the accident of bleeding a
feverish patient in that country, and observing that the venous blood
in the tropics was of much brighter red than in colder latitudes, that
led him to investigations which forever identified his name with the
birth of a new science. A science, in truth, the foundation for every

other science, and which deals with what are termed nature’s forces.
Dr. Mayer’s theoretical demonstration, of the equivalence of heat
and work, was rapidly followed by Joule’s experimental determina¬
tions of the mechanical equivalent of heat. Joule commenced in the
spring of 1844, and in the course of his researches he justified one

of Dr. Mayer’s hypotheses, that in compressing air the heat evolved

was equivalent to the power employed, and vice verm, the heat
absorbed in rarefaction was fouud to be the equivalent of the
mechanical power developed. If compressed air was expanded into
a vacuum no mechanical power was produced and no absorption of
heat expected or found. But when such compressed air, reduced to
ordinary temperature by cold water, is made to move an engine
piston, then it leaves the cylinder so cold that moisture is frozen.
One of our colleagues, a great and worthy example of an industrious
country practitioner, Dr. John Gorrie, of Apalachicola, Fla., based
on this theory an ice machine, which he intended to use for the con¬
trol of malaria and yellow fever. His patent is dated the 6th of
May, 1851, and it is quite evident that, without a knowledge of

Mayer’s theory or J oule’s demonstration, he designed a refrigerating

machine based on the principle just indicated, and which anticipated
numerous patents since secured by Kirk, Windhausen, Giffard, and
a host of minor inventors. Dr. Gorrie proved himself a physicist as
well as an engineer, and in his neighborhood many can testify to his
exalted character as a man and success as a physician. These facts,
bearing on the relation between the science of Medicine and Ther¬
modynamics from Mayow to Gorrie, have been furnished me by one
who has made these questions a special study. Professor John
Gamgee, who, like Dr. Gorrie, wished to apply artificial cold to the
prevention of yellow fever, has supplied me with these data and on
his authority, I do not hesitate to endorse them.
 THE GENIUS OF MEDICINE. 13

It would be difficult for me to avoid touching on the one subject to

which I have devoted much thought during my entire professional life.
The views I promulgated five and twenty years ago of the purely naval
origin of yellow fever have slowly but certainly gained ground, so that
now they are sustained by our knowledge of the geographical distribu¬
tion of disease, and, likewise, by the tendency of all research as to
the nature of putrefactive poison. Sanitary science still compels
the physician to become an accomplished physicist and chemist. No
branch of natural history fails to enlarge his views, and develop
methods calculated to promote the health and comfort of his fellow-
men. Whether in the laboratory, tracing adulterations or evidence
of poisoning, or as travelers studving physical geography and the
distribution of diseases, in every clime, he finds the broad domain of
pure science ever suggestive and essential to his advancement.
Three great English names stand pre-eminent in the field of hygiene.
They are Dr. William Farr, Dr. Edmund Parkes and Mr. John
Simon. Their enthusiastic followers crowd not only Great Britain,
but America, and circumstances have favored the organization of
sanitary authorities in this country, to an extent that twenty years
ago appeared impossible. This is due mainly to efforts of one
modest, but resolute reformer.
We may briefly review that course of events as best known to us,
and which have all occurred during my professional lifetime. From
1840 to 1856 was the formative period preparatory to concerted
effort in favor of sanitai'y reform, on the part of the professional and
scientific readers and observers of passing events. The decade of
1850-60 was that of agitation on the part of sanitarians who gradually
moulded a public sentiment, which was an indispensable foundation
for the abundant work since prosecuted. Massachusetts appointed
its sanitary commission, which made an admirable report on the
health of the people. The Quarantine and Sanitary Convention was
organized and held annual meetings in 1857-8-9 and 1860. Delegates
from most of the States attended, were inspired with the enthusiasm
of new believers and returned to their homes to leaven public opinion,
and encourage all in a conflict against disease. The four volumes of
proceedings published by the convention, embodied discussions on
the more popular questions of hygiene by some of the ablest physi¬
cians and publicists of that day. The first four years of the succeed¬
ing decade, 1860-70, were those of the late war between the States.
Nevertheless, it was the opening epoch of American sanitary legisla-
14 THE GENIUS OF MEDICINE.

tion. The war on the old order of things began in New York city.
Its sanitary government was of the crudest and most contemptible
kind. Its chief officer was a very ignorant politician, and its health
inspectors were keepers of grog shops. Their qualifications may be

estimated by the reply of one to the question : “ What is hygiene ? ”

asked by a legislative committee. He answered : “A mist arising
from low grounds.” Another was asked : “What is the best pre¬
ventive of small-pox? ” To which he replied : “Burn coffee in the
room.” On a health department officered by such men, New York
expended $1,000,000 annually,, At this stage a revolution was
planned, pursued and proved successful. My friend, Dr. Stephen
Smith, the present New York representative of the National Board
of Health, was chiefly instrumental in organizing and directing the
force which effected the reform. Through his efforts the leading
physicians and citizens became interested and united.
When an intelligent people can be instructed, it is not difficult to
upset combinations inimical to public interests; but at the outset,
the most determined advance was most successfully resisted. Legis¬
lative committees would scarcely grant a hearing, but defeat only

stimulated to greater endeavors. A Citizens’ Association was oi’gan-

ized, a fund raised and a complete system of sanitary inspection
perfected for the purpose of preparing a report on the actual state of
the city. Thirty-one sanitary districts were formed, and to each was
appointed a first-class medical man. Every room from cellar to
garret, of every accessible house, was thoroughly examined and an
inventory taken of its contents, size and number of inhabitants.
Back yards, stables, privies, dog kennels, cats, hens, geese, filth,
everything were noted and set forth in records and maps partly
colored. The whole was completed in three months at a cost of
$22,000. It formed the subject of an elaborate report, a sanitary bill
was drawn up, and at the ensuing meeting of the Legislature a
renewed effort was made in behalf of reform. Dr. Stephen Smith
presented the facts of the report, and Mr. D. B. Eaton the bill before
the joint committee of the two houses. The report was completely
successful, the committee being overwhelmed by the most startling
discoveries and indisputable evidence of the gross insanitary state
of the metropolis. The joint committee unanimously reported in
favor of the bill. This soon became law. The public press gave

great prominence to Dr. Stephen Smith’s speeches, and the report

of the Association, prepared for publication by Dr. E. Harris, was re-
 THE GENIUS OF MEDICINE. 15

garded by the best European authorities, such as Parkes and

Pettenkofer, as a model of volunteer sanitary work. The law was
modelled after the English Sanitary Act, and is probably the best
piece of sanitary legislation in the world. An d events now occurred
calculated to consolidate public opinion in favor of such zealous
intervention in the interest of public health. Cholera was introduced
in New York when the new Board of Health had barely organized in
1866. The usual panic prevailed at first, but the new officers grap¬
pled resolutely with the plague, and it soon became apparent that
the disease was under complete control. Each and every new case
was summarily dealt with, the panic subsided, and the season passed
with but a few scattering cases, though the usual virulence and mor¬
tality were witnessed in neighboring towns. The effect of this
campaign was all that could be desired. The reputation of the new
board became there and then established. Other cities, and notably
Chicago, Washington and New Orleans organized on the same basis.
Now comes the last decade, from 1870 to 1880. Approaching the
first year, Dr. Stephen Smith conceived the idea of uniting the ele¬
ments which his industry and intelligence had called into active play,
so as to have an annual conference of sanitarians from all parts of
the Union. A quiet and unostentatious bearing, with a sincere devo¬
tion to work for their own sake, gave Dr. Smith the aid of all, and
some challenged his boldness. At his own expense, and after exten¬
sive correspondence with all devoted to public hygiene in this
country, he called by mutual consent a small meeting in New York,
on the 18th of April, 1872. Out of this meeting grew the American
Public Health Association. Dr. Smith was elected President four
consecutive times, but on the fourth he positively declined acceptance.
He desired to have a representative organization, and insisted on a
general or national, rather than a personal policy, such as is usually
so detrimental to public interests. Too much credit cannot be given
to Dr. E. Harris, its first permanent Secretary, who devoted time
and money freely to the early years of the Association. The work of
the American Public Health Association had a most important bear¬
ing on the development of sanitary thought in this country. Under
the stimulus of its discussions, boards of health, State and municipal,
rapidly multiplied, and large numbers of earnest students were
brought into the field of sanitary inquiry. In his inaugural address,
as President of the Association, Dr. Smith stated the objects in view
as “ the advancement of sanitary science, and the promotion of or
16 THE GENIUS OF MEDICINE.

ganizations and measures for the practical application of public

hygiene.” He discussed the actual potential longevity of man, and

declared that the increased expectancy of life had not arisen from
more successful methods of treating disease, but was rather due to

man’s advance in a higher civilization which enables him to live with

less expenditure of vital force, and which leads him to seek his own
highest welfare in the common efforts to promote the welfare of all.
The organization of the National Board of Health is a matter of
too recent history to demand a statement here, but all may take
courage from the origin of this National effort in attempting to ini¬
tiate reforms such as Dr. Stephen Smith has been the main author of
in the past. I wish specially to allude to the peculiar influence
exerted by a few noblewomen in propounding and testing public health
measures. The first was Lady Mar}’ Wortly Montague, who accom¬
panied her husband, the Ambassador, to the Court of Constantinople.
She learned that the villagers in the neighborhood were in the habit
of inoculating for the small-pox. She performed the operation on
her son, and was afterwards the means of introducing it into England.

This somewhat facilitated Edward Jenner’s efforts, thwarted as they

were by professional jealousy and gross prejudice. He, too, learned
from the people that cow pox preserved them from the attacks, dis¬
figurement and deaths incidental to small-pox, and his discovery
constitutes one of the grandest illustrations of the value of experi¬
ments and induction. Two ladies of noble family had their children
vaccinated and soon opposition ceased, favoring the general accept¬

ance of Jenner's practice. These examples have been almost cast in

the shade by the timely influence of Mrs. Elizabeth Thompson, of
New York, in 1878. She sought wise advice, obtained it through
Dr. Stephen Smith from Surgeon General Woodworth, and the result
was the organization of the National Board of Health. We now feel
that on the shores of the Gulf of Mexico future epidemics of yellow
fever can only be rare and unimportant, unless as the result of gross
negligence, which is likely to be brought home to the door of the delin¬
quents. Yellow fever, as a devastating disease of the American seaport,
may fairly be declared at an end.
I had hoped to have traced the history of American physician physi¬
cists. Time compels me to close, but we have in the Drapers living
monuments of the great school of experiment and induction. Their
names are linked with discoveries in Astronomy, Electricity, Light,
Meteorology and in industrial arts such as Photography, almost
 17
THE GENIUS OF MEDICINE.

crowding from their vision teachings on Ethnology, Physiology and

allied science. The old spirit survives, and in Dr. Gorrie proved
itself fruitful on the shore sands of our State. The object of our
association is to further the interests of our great profession. It
is well to maintain a high standard of excellence in view, and it
is to be hoped that the link shown to exist between the medical
minds of the 17th, 18th and 19th centuries, and leading inventions
of the 18th and 19th, may inspire all to hope for solid advances
in science by increasing devotion and observation on the part
even of overworked medical practitioners. The genius of medi¬
cine has proved itself resplendent in the past. Let each and all
of us not dim the lens which, converging the rays of the past, almost
threatens to blind us. We have but one course to pursue and that
is, onwards.
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